The Department & the Field

The Department of Social Medicine was created in 1978 as a new academic unit to incorporate the long-standing interest of the University of North Carolina School of Medicine in community medicine and health care delivery systems. This interest, which had been represented early on by a Department of Preventive Medicine and subsequently by divisions within Family Medicine, Internal Medicine, and Pediatrics, and by the Cecil G. Sheps Center for Health Services Research, was further advanced with the establishment of the new unit. Although originally called the Department of Community Medicine and Hospital Administration, its broad concern with the social sciences and medical humanities led to the adoption of the name Social Medicine in 1980. While the Department’s current mission and scope far exceed these early seeds in community medicine and health care delivery systems, these focal points remain crucial to Department faculty research, scholarship, teaching and service.

European physicians and social reformers of the 19th century used the term “Social Medicine” as a shorthand to express deeply held ideals, among them,

that social and economic conditions affect health, disease, and the practice of medicine;

that the health of the population is a matter of social concern; and

that society and its leaders should promote health through both individual and social means.

The field of Social Medicine expanded globally over the following decades, with distinct practice styles evolving in Latin America in the 1930s (influenced by Marxist thought), South Africa in the 1940s (the community-oriented primary care model with early roots in the approach of Sidney and Emily Kark), and China in the 1950s (through its “barefoot doctors”). The WHO’s 1978 Alma Atta Declaration embraced important social medicine tenets, such as the unacceptability of gross health inequalities, the people’s right to participate in the organization and implementation of health care, and the universal availability of primary care.

The Department of Social Medicine contributes to ongoing critical debates about the social, political, economic, and ethical implications of medical issues in North Carolina, the U.S. and around the world, while remaining engaged with the day-to-day practices of clinical medicine and research. More recently, it has added to its program residency training for physicians in preventive medicine. It is actively engaged with the School of Medicine’s efforts in health promotion and disease prevention for populations as well as individuals. The inter-disciplinary reach of our faculty strengthens our critical stance towards contemporary medical practice.

Further reading:

D. Madison, “Introduction” to UNC Social and Administrative Medicine, 1987-1988. (UNC Chapel Hill, 1988)
A brief review of early history of the Department.

D. Madison, “Introduction” to Social Medicine, 1993 (UNC Chapel Hill, 1993)
Resonances of the academic term “social medicine” in work of the Department.

D. Madison, “Introduction: Where Medicine and Society Meet,” in Social Medicine, 1998 (UNC Chapel Hill, 1998)
A short history of social medicine in European, US, and UNC contexts.